Definition

This procedure involves the surgical removal of the lining of the uterus (womb). It may involve using heat, cold temperatures, microwave energy, or other methods.

Reasons for Procedure

Endometrial ablation will likely make menstrual flow lighter. In some cases, it stops menstrual flow completely. The procedure is used to treat
menorrhagia
—recurrent heavy periods not controlled by medication.

Talk to your doctor about your plans for having a baby. This procedure decreases your chance of pregnancy.

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have endometrial ablation, your doctor will review a list of possible complications, which may include:

Infection

Bleeding

Complications related to anesthesia

Uterine perforation or organ injury

Edema (swelling) due to fluid leakage and absorption

Thermal (heat) injury to the vagina, vulva, or bowel

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

Anesthesia

Regional anesthesia
—blocks pain in the area, but you stay awake through the procedure; given as an injection

Local anesthesia—just the area that is being operated on is numbed; given as an injection

Your doctor will help you decide which one is right for you.

Description of the Procedure

There are many different ways for the doctor to do this procedure. A simple ablation procedure is short. It can often be done in a care center. Other procedures take longer and need to be done in a hospital.

During the procedure, the doctor will not make any incisions to access the uterus. A tiny probe will be inserted through the vagina and into the uterine cavity through the cervix. Depending on the method, the tip of the probe will expand to deliver:

Electrosurgery—uses electrical current and a heated rollerball or spiked ball); may require general anesthesia

These methods will destroy the cells lining the uterine cavity. You will not feel pain. Often, ultrasound is used to help guide the doctor. Suction will be used to remove the tissue that has been destroyed.

How Long Will It Take?

This depends on the type of method. It can take 15-45 minutes or longer.

How Much Will It Hurt?

You may feel cramping and discomfort. Your doctor will give you pain medication.

Average Hospital Stay

This is usually done on an outpatient basis. You may need to stay there for 1-2 hours. Some methods may require an overnight hospital stay.

Post-procedure Care

At the Care Center or Hospital

While recovering, the hospital staff may:

Check blood pressure, heart rate, and breathing

Check on your fluid status and the electrolytes in your blood

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

Washing their hands

Wearing gloves or masks

There are also steps you can take to reduce your chances of infection such as:

Washing your hands often and reminding visitors and healthcare providers to do the same

Reminding your healthcare providers to wear gloves or masks

Your doctor will ask you how you feel and make sure you are well enough to go home.

At Home

When you return home, do the following to help ensure a smooth recovery:

Talk to your doctor about how your fertility has been affected by the procedure. Discuss family planning options.

Endometrial Ablation. The American College of Obstetricians and Gynecologists, Practice bulletin. No. 81, May 2007.
Obstet Gynecol.
2007 May;109(5):1233-48.

Endometrial ablation. The American College of Obstetricians and Gynecologists website. Available at:
http://www.acog.org/Patients/FAQs/Endometrial-Ablation. Published April 2013. Accessed September 23, 2014.

Heavy menstrual bleeding. National Institute for Health and Clinical Excellence website. Available at:
http://www.nice.org.uk/nicemedia/pdf/CG44NICEGuideline.pdf. Published January 2007. Accessed September 23, 2014.

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